title: Decline of dose coverage between intraoperative planning and post implant dosimetry for I-125 permanent prostate brachytherapy: comparison between loose and stranded seed implants.
abstract: OBJECTIVE
  In permanent prostate brachytherapy the dose distributions 4 weeks post implant differ from the intraoperative dose distributions. The purpose of this study is to compare intraoperative planning and post implant dosimetry for loose and stranded seed implants.
  
  
  METHODS
  This study investigates prostate dose coverage in 389 patients with stage T1 or T2 prostate cancer treated in the years 2005, 2006 and 2007. The patients received either a loose seed or a stranded seed implant. All patients had US-based intraoperative planning and CT/MRI-based post implant dosimetry after 4 weeks.
  
  
  RESULTS
  Intraoperative and post implant D(90) values amounted 183+/-13 Gy (mean+/-standard deviation) and 161+/-30 Gy, respectively. Decline of D(90) values (mean and 95% confidence interval) between intraoperative planning and post implant dosimetry for RAPID strand (n=67), Intersource strand (n=136) and loose selectSeeds (n=186) implants amounted to -40 (-45 to -34) Gy, -25 (-28 to -21) Gy and -15 (-18 to -21) Gy, respectively.
  
  
  CONCLUSIONS
  The patients treated in the period 2005-2007 with stranded or loose seed implants had on average adequate D(90) values of 161+/-30 Gy. Post implant D(90) values were 22+/-27 Gy lower compared to intraoperative planning. Decline of dose coverage between intraoperative planning and post implant dosimetry was significantly larger for the stranded seed implants.
authors.affiliation: Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands. m.a.moerland@umcutrecht.nl
authors.forename: Marinus A
authors.initials: MA
authors.lastname: Moerland
authors.forename: Marijke J H
authors.initials: MJ
authors.lastname: van Deursen
authors.forename: Sjoerd G
authors.initials: SG
authors.lastname: Elias
authors.forename: Marco
authors.initials: M
authors.lastname: van Vulpen
authors.forename: Ina M
authors.initials: IM
authors.lastname: Jürgenliemk-Schulz
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Battermann
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted
chemical_list: D007457:Iodine Radioisotopes